Background:

The focus of the discipline of neuropsychology is shifting towards a greater emphasis on understanding the relationship between assessment results and performance of everyday tasks (ecological validity). To date, the literature has highlighted the importance of this concept in the assessment of patients with brain injury or disease (e.g. in rehabilitation and forensic settings). This paper presents the argument that there is another important area in which the ecological validity of neuropsychological assessments should be considered: in clinical outcomes studies using neurologically intact participants. For example, determining the extent to which a medical procedure or intervention affects performance of everyday cognitive tasks can provide useful information that can potentially guide decision-making regarding treatment options. It is argued that tests designed with ecological validity in mind (the verisimilitude approach), as opposed to traditional tests, may be most effective at predicting everyday functioning. Explanations are proposed as to why researchers may be reluctant to use tests with verisimilitude in favor of more traditional measures.

Longitudinal analyses indicate that social support appears to be an important predictor of HRQOL in women diagnosed with breast cancer. In particular, positive emotional and informational support that may normally be provided by a partner is important in maintaining HRQOL. Identification of those lacking social support, especially patients without partners, will enable them to be guided to appropriate support networks and programs.

The GAI-SF is a short form of the Geriatric Anxiety Inventory, which we recommend for use in epidemiological studies. It may also be useful in primary care and acute geriatric medical settings.

We investigated the hazard perception ability of older drivers. A sample of 118 older drivers (65 years and older) completed a video-based hazard perception test and an assessment battery designed to measure aspects of cognitive ability, vision, and simple reaction time that might plausibly be linked to hazard perception ability. We found that hazard perception response times increased significantly with age but that this age-related increase could be accounted for by measures of contrast sensitivity and useful field of view. We found that contrast sensitivity, useful field of view, and simple reaction time could account for the variance in hazard perception, independent of one another and of individual differences in age.

Strong social support is associated with lower mortality and morbidity and better self-rated health in later life. The aim of this study was to compare social network size and satisfaction in men (N = 2589) and women (n = 3152), aged 72-78 years. Women reported significantly larger networks (Difference 1.36, 95% CI 0.89, 1.83) than men. However, being separated, divorced or single had a significantly greater impact on men's social networks (Difference 0.92, 95% CI 0.17, 1.68). Poor mental health and sensory impairments were associated with smaller networks and lower satisfaction with support for both men and women.

The concept of stages of driving cessation for people with dementia could be used to develop new approaches or adapt existing approaches to driving cessation. Interventions would need to be individualized, optimally timed, and address grief, explore realistic alternative community access, and simultaneously maintain key relationships and provide caregiver support.

The objective of this study is to identify whether decline in cognitive functioning after chemotherapy in women with breast cancer is associated with health/disease, treatment, and psychological variables. Neuropsychological performance, health/disease, and treatment-related information of 136 women with breast cancer (age M = 49.38; SD = 7.92; range = 25.25-67.92) was assessed pre-chemotherapy and 1-month post-chemotherapy. The Reliable Change Index corrected for practice (RCIp) identifi ed women whose performance signifi cantly declined, while Pearson correlations assessed the relationship between cognitive change and predictor variables. A total of 16.9% of women showed signifi cant decline post-chemotherapy, with affected domains including verbal learning and memory, abstract reasoning, and motor coordination. Decline in hemoglobin levels and increased anxiety over the course of chemotherapy was found to signifi cantly predict impairment in multiple cognitive measures. Change in specifi c cognitive measures was signifi cantly associated with baseline fatigue, depression, and functional well-being ( r = 0.23 to 0.33; p = .01 to < .001). Although the effects are small, there is evidence that psychological and health factors may increase vulnerability to cognitive dysfunction after chemotherapy for breast cancer. Signifi cant associations reported in this study may be useful in the identifi cation and treatment of at-risk individuals. ( JINS , 2009, 15, 951-962.)